Clare Daly (Dublin North, United Left)
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455. To ask the Minister for Health further to Parliamentary Question No. 192 of 24 June 2015 in relation to the newly-instituted national incident management system, where severity ratings are being assessed by the local health care organisation at time of reporting, the training that has been given to local staff to handle the reporting and rating of the severity of incidents; and the review and oversight mechanisms that are involved in maintaining the quality control of these severity ratings which are filled in locally. [36199/15]

Leo Varadkar (Dublin West, Fine Gael)
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Under the National Treasury Management Agency (Amendment) Act 2000 there is a statutory requirement for all State authorities including the HSE and its funded agencies to report adverse incidents promptly to the State Claims Agency (SCA) and to facilitate any subsequent investigation. This allows the HSE in conjunction with the SCA to identify and analyse developing trends and patterns and to develop and implement risk mitigation strategies.

Considerable work has been undertaken in the first six months of 2015 in the roll out the new National Incident Management System (NIMS). At the end of June 2015, the former ‘STARsWeb’ system was ‘switched off’. NIMS is now the national (and only mandated) platform for reporting incidents. It provides a powerful reporting tool that supports incident investigation, tracking of recommendations from investigations and analysis of adverse event trends, all of which should inform the risk strategies of each health service organisation.

In terms of the quality of data;

- This is supported by the NIMS intelligent interview entry forms, incorporating specific questioning and picklists, along with mandatory field validations which are designed to standardise reporting across the health sector. This will also lead to improvement in data quality.

- Certain NIMS information is automatically generated by the system through built in algorithms. An example of this is the "severity rating" which is based on the injury outcome. This algorithm follows the Impact table for clinical and non clinical incidents, which is set out in the HSE’s Safety Incident Management Policy, and results in the generation of an objective, system-driven "severity rating".

- NIMS provides the capability for the user to conduct a risk investigation and update the injury outcome as appropriate, allowing for a reclassification of the system generated "severity rating".

- The State Claims Agency, as the host of NIMS, has also established a data services section which monitors the quality of data on NIMS on an ongoing basis.

As part of NIMS, a new taxonomy consistent with the World Health Organisation taxonomy was introduced to facilitate more consistent reporting. The benefits of this will be seen as the system becomes the established reporting tool for both serious and less serious incidents.

As part of the roll out programme for NIMS, almost 700 people have been trained to enter incidents on the system. Further training is currently underway to allow each service produce reports on its own data.

Clare Daly (Dublin North, United Left)
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456. To ask the Minister for Health further to Parliamentary Question No. 192 of 24 June 2015, when it is expected that the national incident management system will feed into the development of a comprehensive information base, publicly available for purposes of comparison, similar to the United Kingdom's national child and maternal health intelligence network. [36200/15]

Leo Varadkar (Dublin West, Fine Gael)
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The new National Incident Management System (NIMS) is an end-to-end risk management tool, the purpose of which is to provide the HSE and HSE-funded services with the information to manage incidents throughout the incident lifecycle, that is from reporting of incidents to management of investigations, to tracking of how the recommendations following such investigations are being implemented. It will be an important management tool for understanding and learning from incidents with a view to improving patient, service user and staff safety, while continuing to fulfil the legal requirement to report incidents to the State Claims Agency.

Phase 1 implementation of NIMS, which deals with the recording of incidents and which replaced the STARsWeb System was completed in June 2015.

Planning for Phase II is well advanced and will provide for management of investigation and the development of a standard suite of reports to support the management of incidents. Also, as part of this Phase II the HSE, in conjunction with the State Claims Agency, will be considering the format and content of information to be published and international practice in this area will be examined, in order to inform those considerations.

Clare Daly (Dublin North, United Left)
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457. To ask the Minister for Health further to Parliamentary Question No. 468 of 23 June 2015, and given the acknowledged role that the Health Information and Quality Authority has in carrying out investigations regarding serious shortfalls and shortcomings in maternity units, the reason the Health Service Executive is conducting internal inquiries. [36201/15]

Clare Daly (Dublin North, United Left)
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458. To ask the Minister for Health if the Health Information and Quality Authority has been appointed as the external reviewer for the review of Portiuncula Hospital in County Galway; if not, the reason; and if he will make a statement on the matter. [36202/15]

Leo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 457 and 458 together.

The safety of service users is of paramount importance and steps need to be taken to anticipate and avoid things going wrong and to reduce the impact if they do. Creating a culture of open disclosure and learning from the things that go wrong is the bedrock of making systems safer. It is in this context that the HSE requires all safety incidents to be reported, managed and investigated.

The HSE's National Safety Incident Management Policy 2014 and the Guidelines for Systems Analysis Investigation of Incident and Complaints 2012 were developed by the Executive to protect patients and ensure that robust investigations are carried out. The policy sets out the steps to be taken when an investigation is required and has been developed in line with international best practice in patient/service user safety and risk management.

The HSE recognises that some incidents, due to their seriousness, complexity, or where there are matters of significant public concern, will require investigations to have an additional level of independence. In the acute hospital sector the HSE has formal arrangements in place with the Forum of Postgraduate Training Bodies in Ireland and Royal Colleges in the UK for seeking nominations to Chair or participate in investigation teams. The use of these external experts is the exception rather than the rule.

At the request of the Chief Clinical Director, Saolta University Healthcare Group, the Executive's National Incident Management and Learning Team established a Review of the Maternity Services at Portiuncula Hospital, Ballinasloewith an independent Review Team, chaired by Professor James Walker, Professor of Obstetrics and Gynaecology, University of Leeds and supported by trained investigators. The Review team are working towards the Review being completed by the end of this year.

Under Section 9 of the Health Act 2007 the Health Information and Quality Authority (HIQA) may undertake an investigation as to the safety, quality and standards of services provided by the Health Service Executive if the Authority believes that on reasonable grounds there is a serious risk to the health or welfare of a person receiving those services. I, as Minister, also have powers under the Health Act 2007 to request an investigation in particular circumstances. In the case of the Portiuncula Review I will await the outcome of the HSE Review Team's work before deciding if any further course of action is appropriate.